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"etiology": "<p><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">Врожденные пороки сердца могут быть спровоцированы воздействием негативных факторов на ребенка во внутриутробном периоде (особенно в первые 3 месяца беременности).</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 7pt; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Заболевания матери во время беременности (могут действовать на плод неблагоприятно, в ряде случаев вызывая недостаточное или неправильное развитие):</span></p>\r\n<ul style=\"margin-top: 0; margin-bottom: 0; padding-inline-start: 48px;\">\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">хронический алкоголизм;</span></li>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">краснуха (инфекционное заболевание, вызываемое вирусом краснухи, проявляющееся красной сыпью на теле);</span></li>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">грипп (вирусное простудное заболевание);</span></li>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">сахарный диабет (заболевание, связанное с недостаточностью или неполным усвоением инсулина – гормона поджелудочной железы);</span></li>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">аутоиммунные заболевания (заболевания, при которых собственные клетки воспринимаются защитной системой организма как чужеродные).</span></li>\r\n</ul>\r\n<p><span style=\"background-color: transparent; font-size: 7pt; white-space: pre-wrap;\">Физические факторы (в основном, это действие радиации), вызывающие различные мутации и уродства. К ним относятся и лучевые методы исследования (рентгенологическое исследование), которые должны выполняться по очень серьезным показаниям, а лучше быть заменены другими способами исследования.</span></p>\r\n<p><span style=\"font-size: 7pt; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Химические факторы:</span></p>\r\n<ul style=\"margin-top: 0; margin-bottom: 0; padding-inline-start: 48px;\">\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">алкоголь;</span></li>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">никотин;</span></li>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">наркотические вещества;</span></li>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">некоторые (в особенности сильнодействующие) лекарственные препараты.</span></li>\r\n</ul>",
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"diagnostics": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Диагноз предполагают на основании клинических данных, с учетом рентгенографии органов грудной клетки и ЭКГ, точный диагноз устанавливают на основании двухмерной эхокардиографии с цветной допплеркардиографией. Катетеризация сердца часто необходима для уточнения сопутствующих аномалий перед операцией.</span></p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Рентгенография грудной клетки демонстрирует кардиомегалию различной степени выраженности с усилением легочного рисунка, право расположенной дугой аорты (примерно у 30 %) и относительно высокое расположение легочных артерий. На ЭКГ часто обнаруживают гипертрофию обоих желудочков. Существенное усиление легочного кровотока может вызывать появление признаков и гипертрофии левого предсердия.</span></p>",
"treatment": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Консервативное (безоперационное) лечение используется для лечения осложнений заболевания и для предоперационной подготовки.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Лечение самого дефекта общего артериального ствола только хирургическое. Желательно проводить его в первые месяцы жизни.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">Паллиативная (временно облегчающая, но не излечивающая) операция Мюллера-Альберта у пациентов с тяжелой формой заболевания – на легочную артерию накладывается специальная манжетка, суживающая просвет сосуда и уменьшающая сброс смешанной крови в кровеносное русло.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">Радикальная (полностью устраняющая причину) коррекция порока (в основном применяется в настоящее время) — используется хирургическая операция, которая состоит из трех этапов:</span></p>\r\n<ul style=\"margin-top: 0; margin-bottom: 0; padding-inline-start: 48px;\">\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">прекращение сообщения между аортой и легочной артерией;</span></li>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">закрытие дефекта межпредсердной перегородки при помощи заплаты;</span></li>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">создание искусственного ствола легочной артерии с помощью специального протеза.</span></li>\r\n</ul>\r\n<p><span style=\"background-color: transparent; font-size: 7pt; white-space: pre-wrap;\">Успешное хирургическое восстановление нормального кровотока проводится в первые месяцы жизни. Это сложная операция, проводящаяся на открытом сердце с использованием аппарата искусственного кровообращения.</span></p>\r\n<p><span style=\"font-size: 7pt; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">В дальнейшем, при удачном исходе, пациент находится под регулярным наблюдением специалистов и принимает специфические препараты, регулирующие кровоток.</span></p>\r\n<p><span style=\"font-size: 7pt; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">С возрастом необходимо выполнять дальнейшие тяжелые операции по реконструкции сосудов, обусловленные недостатком современных синтетических материалов.</span></p>",
"prevention": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Минимизация негативного воздействия на плод во время беременности матери:</span></p>\r\n<ul style=\"margin-top: 0; margin-bottom: 0; padding-inline-start: 48px;\">\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">благоприятное социальное и экологическое окружение;</span></li>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">предотвращение вредного химического воздействия на плод (алкоголь, наркотики, лекарственные препараты, другие химикаты);</span></li>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">ранняя диагностика пороков развития у детей во внутриутробном периоде благодаря современным генетическим методам исследования.</span></li>\r\n</ul>",
"clinical_picture": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Симптомы этой патологии связаны с хронической гипоксией (длительным недостаточным насыщением крови кислородом):</span></p>\r\n<ul style=\"margin-top: 0; margin-bottom: 0; padding-inline-start: 48px;\">\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">одышка (значительное учащение дыхания, в особо тяжелых случаях до 50-100 в минуту);</span></li>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">быстрая утомляемость;</span></li>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">потливость;</span></li>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">увеличенная печень и селезенка;</span></li>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">синюшность кожных покровов (от минимальной до значительной);</span></li>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">возможна деформация ногтей по типу «часовых стекол» (утолщенные, закругленные, выпуклые) и пальцев рук по типу «барабанных палочек» (с утолщениями на концах пальцев);</span></li>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">возможно формирование сердечного горба (деформация грудной клетки в виде выпячивания в области сердца);</span></li>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">значительное отставание в физическом развитии.</span></li>\r\n</ul>",
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}
]
}
